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� � �ERMIT APPLICATICS�� <br /> BUILDING/MECHANICAL/PLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.a�verettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM!AM TO 4 PM 9 �O�`� ( <br /> aITEADORES3: PROPEI1iYTA%11 PE � 'D <br /> 1 03 PA�rJ6 FIELO WhY EV�RG11 WA b.•7"1 <br /> LEGAI lor newconstruction: Short PlaVsubdivisionG:Prl�iSia�C��6:�.�_Lol No.� (atlach copyof lonp lepal Eescdption) <br /> OWNER + � ' ,�� oMcS NW 1_l_C Phone/E-ma�l (`1i5� 33� -55° � <br /> Address rJ 6�X 14'�t'1 City/5tateiZip M�..� �=EEK �A y�o�� <br /> CONTRACTOR (_,o'i =u5-r, � �-�oM'c.3 N�� �-l-L L 61 Lic.# C�::�R N t �-1 N 94� C A <br /> C42S �i>:-S:tii; <br /> Address PU Qu�. ���`{Zy (�11u C.REEk �J.4 9�J�t2 PhonelEmail .iqn��:�N„SZtNeHal�'IES.uS <br /> TENANTBUSSNESSNAME CONTACTFORPERMIT �„�qn- �MPo�-h <br /> Phone/E-mail \4Zs133'C-S55� M�e.wta�nnr_H,.rn�S.US <br /> BUILOING PERMIT APPLICATION —;ONTRACT PRICE OF WORK_ <br /> Existing Use of Bui�ding_ �� _ HEAT SOURCE: <br /> Proposed Use of Building__�__ Gas_�_ E�ectric____ Other____ <br /> Building lype: X Single Family __ Duplex_Townhouse __Multi-Family __Commercial <br /> Type ot project: X.New ___Addition �Remodel __Repair_T.I._Sign�Sprink�er___Demolition_Change of Use <br /> Descriplion o(Work(additional space providedon fhe back): <br /> l��sic, � �i�3 � P�r.� IIGI r�� <br /> Have you started workinp without a permit4 _YES _�NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol ProJect: �New__Addn __ Altaration___Repdr Type of Pro�eet: �N�w___Addn _Alteratlon_Rep�ir <br /> ShowNumber R o/fluturoi ShowNumWr o/flAluns <br /> A/C-air handlin units 3 Toilet <br /> Forced air s slems 2 Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fre lace I Kitchen sink 6 dis sal <br /> Gas ren e Dishwasher <br /> Clothes d er 1 Cblhes washer <br /> Ran e hood �C Water heater <br /> y Exhaust tan Sink servicelbar/mo letc. <br /> Heat um Backflow reventer <br /> Unit healer Urinal <br /> Boiler Drinkin Founlain <br /> Refn eration Floor drein <br /> Woodstove Grease tra <br /> � Ductin Rocf drains <br /> Other____�____ Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify lhal I have read and ezamined this applicalion end know the same lo be Irue and cortect.All provisbnn ol laws end ordinances goveming <br /> Ihis type of work will be complied wilh whether specified herein or not.The granling of a pertnit dces nol presume to pive authority to vidale or wncel <br /> Ihe provision ol any olher slate or local law regulaling construction or Ihe peAormance of consiruction.Thal 1 am aulhaized by Ihe oNner of Ihis property <br /> lo peAorm Ihe work for which applicalion is made and I wmply with Ihe State Contracton Law 78.27 RCW end 298200 WAC <br /> �'�?,,� �iw:,rt� 8�I 5 �11 ��� <br /> OwnerlAuthori:ad Apant Sipnatura Date (Revised 2I101 iJ <br />